Residential reasoning: how childless older adults choose between ageing in place (AIP) and institutionalisation in rural China

Abstract

The decision of whether to grow old in one's home (also referred to as ageing in place (AIP)) or relocating to an institution is an ongoing negotiation process, which involves residential decisions and adaptation. This research aims to explore how childless older adults in rural China choose between AIP and institutionalisation. Through a qualitative study conducted in rural China among childless older adults, we explored the reasons why they make certain residential choices and how they adapted during the decision process. Twenty-five childless participants (aged 60–83) were interviewed. Findings suggested that they referred to the term ku (literally meaning ‘bitterness’; and a metaphor referring to ‘conducting farming and farm-related activities’) to explain their residential decisions. If a person could endure ku – sustain food and basic living through farming and farm-related activities, they tended to choose to age in place; otherwise, they chose to relocate to institutions. Ku represents a sense of mastery, encompassing the stressfulness and suffering aspect that requires adaptation. Three adaptive strategies were identified: (a) positive reappraising of the negative aspect of ku, (b) routinising ku, and (c) transcending the narrative of ku into a toughness identity. Our findings suggest that childless older adults struggled to achieve residential mastery while making residential decisions, even though a sense of mastery was shaped by the individual and structural constrictions.